PERTINENT FINDINGS: In this single-center [68Ga]Ga-PSMA-11 PET/CT imaging study comparing cfDNA levels with PSMA-TV in 148 men with histologically proven PCA (hsPC, n = 74; CRPC, n = 74), cfDNA levels were only weakly associated with high-volume CRPC and, contrary to the PSMA-TV, not associated with OS. This evidence concerns the gene FOLH1 and posterior cortical atrophy.